Carolyn Elizabeth Johnson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810003775 Issued in VA

Practice address

145 Ednam Dr Ste 301
Charlottesville, VA 22903-4625

Phone

(434) 284-1574

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1174016000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5062 OLD FOX TRAIL CT",
            "city": "CROZET",
            "state": "VA",
            "postal_code": "229323142",
            "telephone_number": "434-284-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 EDNAM DR STE 301",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229034625",
            "telephone_number": "434-284-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sage Stout Johannessen, DPT
• Jay A Johannigman, MD
• John H. Knight, Jr. DDS & Associates
• Jainy John, CRNA
• Dearing W. Johns, M.D.
• Chelsea Johnson, OD
• Danielle Johnson, D.O.
• Dianne E Johnson, FNP
• Emily B Johnson, PA
• Erin Joyce Johnson, LPC, LMFT

• Clinical Psychologist in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.